HomeMy WebLinkAbout032-539-03-5207-LUP-2008-362 Application for Land Use Pernlit (*Shoreland*) o o , "'
County of Saw�Ter � � �
:�}� PO Box 676 -Hayward V�II 54843
J 715/634-8288 �
*Property that is located within 300' of a creek, river or stream or within 1000' oi'a �
flowage, lake or pond or has any of the above waterbodies located within �
the property's boundaries. �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL RE(ZUIRED PERMITS HAVE BEEN ISSUED.
PRINT-USE BLACK INK OR PENCIL
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Owner Builde;r �:
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Mailiri Ad ress � O �
Mai ing Address g
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City, State, Zip City, �State, Zip
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Daytime Phone Daytirne Phone �
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Additional Information: Zone District: F� t
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Lot D:imensions: o� � ( � � ,�
Date lot was created: Acres;: V , �
Is there wetland near the proposed structure? If yes, how far � � +,�, ,,-� ,.r 't �'r� ����� `L� o
Building Land Use Floodplain: ( ) Yes ( " No �
(Xj New ( ) Filling Chippewa Flowage: ( �Yes � N�� �
O Addition O Dredging Driveway access off of a(Check one): � �
( ) Alteration ( ) Grading ( ) Private Rd � Town Rd. � �
( ) Moving On ( ) ( ) County Hwy ( ) State Hwy W �'
O O �' � °
N v, r-+
Pri��.ury Structu�e Accessory Building Addition , o �
(�Q Dwelling ( ) Garage-attached/cietached ( ) Deck � �
(� Year round ( ) # of car stalls ( ) Porch � W
( ) Seasonal ( ) Storage Building ( ) Enclosed � �
O Frame built on site O Screenhouse O Living room i c�
a �
( ) Modular/manufactured ( ) Greenhouse ( ) Kitchen W�
( ) Mobile/manufactured ( ) Other ( ) Bedroom � .-
( ) Other primary structure ( ) ( ) Relocate/enlarge �
( ) ( ) ( ) # ofnew �
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Additional Information: o �1 ;
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Type of Construction: o �
(� Frame ( ) Log ( ) Pole/metal ( ) Block ( ) Concrete � �` l�
( ) Other �' n; y
Construction Cost: Primary Structure $ � . (� 0 �
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Accessary Building: $ `-- Aczdition: $ `--" ~; I�J
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Deed: V ol�_Pg�'1�' Certified Soil Test# q��b��_ �
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CSM: Vol Pg Lot# Sanita:ry Permit# �I�rcGZ3 � d�-� � 7�
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Plat Envelope Or: �,
Condo Vol Pg Year Installed: �;
"Loads and Flows": Vol Pg Owner•When Installed: � �
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Previous office approvals/actions: �
Variance: # �g—�l5 LUP:# SP: ;� CUP: # �
Inspection Report: # �q-�y y Change of Zone District: 1�IZ`�I��_
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Describe the construction using these columns. List the dimensions of each structure in a separate
column. List each story, each addition, each alteration in a separate column. �
#1 . t15e #2. #3. #4.
Size ft. wide ft. wide ft. wide ft. wide
�'�_ ft. long ft. long ft. long ft. long
Floor area 13� sq. ft. sq. ft. sq. ft. sq. ft. •
Hgt. from grade 11; (�„ to peak ft. hgt. ft. hgt. ft. hgt.
Stories �_ stories stories stories
# of bedrooms �_
Lake/Pond/Flowa r/River/Stream (Name)
��e � �-�fQG��°�
Fire Number and Name of Road N �� �/ � M� .1 ��(;I
1 . Enter lot dimensions and indicate north by arrow. Signature of C)wner or Authorized Agent:
2. Indicate the location and size of the requested construction 1��-��. 1�.,
Signature
activities. ����� � . �
Print Name: � ��"
3. Also, indicate the location and distance to the well, The above certifies th�at the listed information and intentions are
true and correct., that all work shall be performed in compliance
septic tank and drainfield, wetland areas, lot lines, with the requirements of the Sawyer County Zoning Ordinance
and the laws and requlations of the State of Wisconsin, and if
centerline of the road and waterbodies. a�t��s as ow�er�s� a�ie�t, has the permission of the owner(s) to
perform the work re�quested on this application. The above
persons/s hereby give� permission for access to the property for
onsite inspection.
Permit fee: $ �� • d�
Total land area within 300' of the waterbody: (A) a(u ��p �
Total impervious surface area [including this project] (B) t�j��_
(B) / (A) x 100 = % Used 7 °�a (Shall not exceed 15%[or 25% with a conc�itional use permit].)
Shoreline Vegetation Protection Area: Mitigation Requ�ired? � Yes O No
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Issue Date Signatur�e of Iss 'ng ent
D (t ��,r/ z �] 2 C,09 50% Rule: Average Road Setback:
Expiration Date
Office Comments:
Sa�;�Ter Countv Zaning Administration � .V .
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Inspection Report '�' =' '
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Oc�-ner(s} Ste��en B. & �far�- L. Kin� b08 a26-3�F11 z
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�ddress i�7Q79 Sunrise Lane Holmen ti�-I �463b "
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A�ent��`Purchaser 74�#4� ��1alm RoaQ �
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�ddress w' �
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S�dr;Plber;`CST �� �
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t�ddress � "'
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Ir�spection � Pri�•ate � Public �'iolation ❑ Zoning ❑ Sanitation �
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� D�t•�Iling 1 Mobile Home � Conzm�rcial ❑ Garage Q Addition �,
�� Setb4cl: - Lal:e i � Setback - Road �j Setbacic - Lot Line ❑ Soils Verification �"
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� Setback - VG'etland - Replacement D���elling Varianee Required �• �
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SCALE: I INCH= 400 FEET FOR ASSESSMENT USE ONLY NQ�
DRAWN BY: D.M.E. DATE: ! -24-I°I 79 INTENDED TO SHOW CONCLUSIVE
COLON (:) INDIGATES GOVT. LOT EVIDENCE OF OWNERSHIP OR
BOUNDARY LOCATIONS
SI�ORELAND PRESERVATION AGRTEMENT �
(Non-Intact Shoreline VeEetation Protection Area)
Land Use Permit No.�8'J�Z (To be entered by the Zoning Office) Index No. U8 v�Z
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WHEREAS, (list all owners)
,
owns real estate within Sawyer County that is subject to the Sawyer County Shoreland Regulations, and
WIIEREAS,in order to secure a Land Use Pemiit.
NOW, THEREFORE, the owner(s) hereby certifies that, as a condition of issue of said Land Use Permit, that
the SHORELINE VEGETATION PROTECTION P,REA on said real estate shall be restored in accordance
with the Mitigation Plan and Implementation Schedule approved by the Sawyer County Zoning Department.
The owner(s)hereby agrees that at all times in the future, the real estate subject to this Agreement shall comply
with all shoreland vegetative buffer requirements of the Sawyer County Zoning Oidinance in effect on the date
that the Land Use Pernut is issued by the Zoning Office. The owner(s) further agrees to allow authorized
representatives of the Governmental Unit to enter onto the owner's property at the following description to
inspect the structure(s) or uses authorized by said Land Use Permit and to determine if the SHORELINE
VEGETATION PROTECTION t1REA exists and that it is being preserved. Violation of this Agreement will
authorize, in addition to other penal6es and relief required under the Sawyer County Zoning Ordinance,
injunctive relief, restoration of said real estate, the revocation of said Land Use Permit and the removal of all
structures approved by the issue of said I,and Use Permit and the revocation of any other uses approved by the
issue of said Land Use Pernut. All parties agree that this Agreement shall be filed with the Sawyer County
� Zoning Office.
�- Legal Description of Property: �ar� ot l�o u�� �r�� � � .S � �� 9^� � J w `
�. � I ` a `7 l�olun,sc (.el a. �e�o�cLs 3q �/ !� . !o� a�re s
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Dated this day of 2 i' , d�
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' � (Owner) (Owne
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This insWment was drafted by:
Sawyer County Zoning Office
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